低血糖昏迷引起海马受累
2013-03-21 12:45:40 来源：
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低血糖昏迷引起海马受累低血糖昏迷引起海马受累
A 55-year-old diabetic man presented with coma for 2 days. Neurologic examination did not reveal any lateralizing signs and moderate hypoglycemia (43 mg/dL) was noted. Under the assumption of hypoglycemic coma, 50% dextrose solution of 50 mL was given IV, which normalized his mental status. Brain MRI showed high signal intensity le-sions in the bilateral hippocampi from CA1 to CA3 areas (figure), which were vulnerable areas on experimental hypoglycemia.
Neuropsychological examination showed marked anterograde amnesia, which persisted over 2 months.
55岁男性糖尿病患者，昏迷2天。神经查体未见明显阳性体征。血检提示低血糖（43mg/dL）。拟诊为低血糖昏迷，静脉予50mL 50%葡萄糖后意识恢复。行头颅MRI提示双侧海马区CA1至CA3区高信号（见图像）。海马的CA1至CA3区域被认为在低血糖模型实验中最易受累。
之后该患者有长达2个月顺行性遗忘的神经心理学症状。
Diffusion-weighted MRI shows hyperintense lesions in the bilateral hippocampi (A), which are hypointense on apparent diffusion coefficient map (B). Coronal view depicts that the abnormal signals are located in the hippocampal areas from CA1 to CA3 (C).
弥散加权成像（DWI）提示双侧海马区高信号（A），而表观弥散系数图像（ADC）显示低信号（B）。从冠状位上看，病灶位于CA1至CA3海马区（C）。
REFERENCE
1. Paschen W, Bengtsson F, Rohn G, Bonnekoh P, Siesjo B, Hossmann KA. Cerebral polyamine metabolism in revers-ible hypoglycemia of rat: relationship to energy metabo-lites and calcium. J Neurochem 1991;57:204–215.
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